MASSAGE

MASSAGEMassage is one of the oldest of the Health sciences and has been used for curative purposes since time immemorial. Massage treatment uses "TOUCH" to apply pressure to the body's skin, muscles, tendons, ligaments.

The Idea of Massage is to ease disorders by;relieving tensionpromoting blood flowcalming nervesloosening muscleCLASSIFICATION OF MASSAGE :

CLASSIFICATION OF MASSAGE: 4 types On the basis of character of technique 1.Stroking 2.Pressure 3.Purcussion 4.vibration

On the basis of depth of tissues approached1.Light massage2.Deep massage

On the basis of part massaged1.Local massage 2.General massage

On the basis of means of administration of technique1.Mannual massage 2.Mechanical massage

Modes of Therapeutic MassageStrokingEffleurageKneadingFrictionWringingPicking upHackingClappingShaking & VibrationStroking- Stroking is performed with the whole hand or fingers. It comprises the usage of relaxed hand over the patient's skin with a rhythm and pressure that produce a relaxing effect.

Effleurage- Effleurage is performed by spreading and moving the hands with pressure and speed, to gain relaxation and lymph drainage.

EffleurageStroking of the skinPerformed with palm of hand Stimulates deep tissuesPerformed with fingertipsStimulates sensory nervesSuperficial, rhythmic stroking: Contours the body or relates to direction of underlying musclesDeep stroking:Follows course of veins & lymph vessels

EffleurageMay be performed slowly for relaxation or rapidly to encourage blood flow & stimulate the tissuesPerformed in rhythmic mannerOne hand should always be in contact w/ skinLight effleurage is performed at beginning & end of massage or may be used between petrissage strokesAt beginning relaxes patient & indicates area to be treatedAt end calms down any irritated areas

PetrissageLifting & kneading of skin, subcutaneous tissue, & musclesPerformed with fingers or handSkin is gently lifted between thumb & fingers or fingers & palm & gently rolled & kneaded in the handOften performed without lotionFrees adhesions by stretching & separating muscle fiber, fascia, & scar tissue while assisting with venous return & milking out waste products

Kneading- Kneading involves alternate compression and release of the part to be manipulated.

Picking up- Picking up involves lifting up of tissue from underlying bone, releasing it after squeezing it.

Wringing-Wringing technique lifts up the tissue and applies a twist to enhance stretching effect.

FrictionTransverse: Applied with thumbs or fingertips stroking the tissue from opposite directionsCan use elbow, end of rolling pin, etc. for larger areasReaches deep tissuesBegin lightly and then move to firmer strokesMuscle should be placed in relaxed positionShould be avoided in acute conditionsEffective in tendonitis or other joint adhesions

FrictionGoal is to mobilize muscle & separate adhesions that restrict movement & cause painFacilitates local blood profusion Not necessarily a pleasing treatmentCircular: Applied with thumbs working in circular motionEffective in treating muscle spasm & trigger pts.

Friction- Friction is a small movement applied with thumb or finger where pressure is applied from superficial to depth of the tissue.

TapotementGentle tapping or pounding of the skinMost common form uses ulnar side of wrist to contact skin karate chopWrist & fingers are usually limp, alternate method cups the handPromotes relaxation & densitization of irritated nerve endings

Hacking- Hacking is performed with extended forearm and striking the skin using the side of the hand .

Clapping-Clapping is done by striking the skin with cupped hands.

Shaking and Vibration-Shaking and vibration involves gentle strokes of shakes and vibrations respectively

AdvantagesRelief of painMuscle tightness is relievedGeneral relaxationInduce sleep in insomnia (sleepless nights)Relieves tensionSkin is tonedDrainage of oedema or swellingLoosens secretion in the Lungs

Where not to Massage?

Large open woundsBurnsSkin UlcersGross Oedema (severe swelling)Extremely Hairy areasSensitive skinBacterial infectionsSkin diseaseMalignancies like cancer

PHYSOILOGICAL EFFECTS OF MASSAGE:As therapeutic modality, massage is used for the relief of pain, Swelling muscle sprain, restricted movements, tension and anxiety associated with a large no. of disorders afflicting muscular, nervous, cardiovascular, respiratory and other systems. It is the magnitude ,duration and the direction of force applied during massage that determines the effect produced on the body. Massage affects almost all systems of the bodyIncreased venous and lymphatic flow. Increased arterial blood flow to the muscle and skin Decreased stagnation of fluid in tissues spaces. Increased removal of waste products of metabolism Increased WBC, RBC, and platelet count in blood. Increased nutritive exchange between blood and cells Increased trophic status of the part massaged Induce sedation Decrease pain Facilitate contraction in hypotonic muscles Modulate autonomic responses

Decreased excitability of motoneuronal pool in neurologically healthy person Increased removal of secretions from lungs Increased gaseous exchange across pulmonary capillaries Increased removal of dead cell from the skin Increased activity of sweat and sebaceous glands Lowers psychosomatic arousal such as anxiety and stress Mobilize soft tissues and breaks soft tissue adhesions Accelerates various metabolic processes by increasing arterial blood flow and venous lymphatic drainage Promotes lypoylsis

THERAPEUTIC USES:

Massage is one of the oldest form of treatment for human ills In physiotherapy, massage is used for the following purposes:

To improve the mobility of soft tissues To reduce muscle spasm and pain To reduce edema To increase blood circulation To mobilize general secretions in the lungs For local and general relaxation massage is indicated in a number of neurological , musculoskeletal and psychosomatic disorders as follows; hemiplagia, paraplegia, quadriplegiafacial/ bells palsy

Muscular weakness, muscular dystrophy, hemiparesis Cerebral disorders upper and lower motor neuron lesions sciaticaAnxiety insomnia Hysteria Different types of headache obesity, flatulance, constipation, inflammation Muscular injury and sprain Venous congestion Teno synovitis, tendenitis, fibrositis